A Day in the Life at WBA: When the pharmacist knows first-hand

Specialty pharmacy manager Joynell Bean at work this month at her hospital-based Walgreens in New Orleans, which focuses largely on providing treatments for multiple sclerosis.

 
Last month I was promoted to pharmacy manager at the Walgreens specialty pharmacy at Touro Infirmary in New Orleans. I feel very protected here, which might seem funny to say, working in a big-city hospital during a pandemic.

There was a lot of anxiety when this all started because Louisiana was one of the states hit hardest and fastest by the coronavirus. But Walgreens has taken a number of measures to help keep us safe, including installing plexiglass shields between us and patients. Every 30 minutes we’re wiping counters down, and washing our hands multiple times a day. We wear masks the entire time we’re here – a requirement not only by Walgreens but also by the hospital. The hospital checks our temperatures before we can enter the building. We still do bedside deliveries to patients who are being discharged, but overall we’re seeing fewer patients in person – mainly because clinics at Touro have canceled most in-person appointments and are doing telehealth instead. Many surgeries have been rescheduled. It has brought down foot traffic from people who might ordinarily pick up their prescriptions from us while they’re at the hospital.

We’re still helping as much as ever – just in different ways. But that’s nothing new for this type of Walgreens.

Our specialty pharmacies are exactly that: community pharmacies that focus on chronic or complex medical conditions that require “specialty” medications and expertise. There are more than 300 of these locations across Walgreens, specializing in HIV, cancer, transplants and more. My location is the main specialty pharmacy for multiple sclerosis (MS) in Louisiana. We see patients with other conditions, and we fill regular prescriptions, like any neighborhood Walgreens would. But most of our specialty focus is on MS, a chronic disease of the central nervous system that can become debilitating if not treated properly and early.

Many of our patients are on immuno-suppressants. With the coronavirus, we don’t want them to compromise their immune systems coming out to pick up a medication when we can simply ship it to them. We say, “You stay at home – we’ll send it to your house.” A lot of them are very grateful for that.

I relate to MS patients, especially – not just during a pandemic, but in normal times. I know what it’s like for them to have to manage this condition.

Why? Because I have MS myself.

Surprise diagnosis

It came on suddenly eight years ago. Looking back, I had subtle symptoms before that – mainly fatigue – but being a mom of two kids, a wife and a pharmacist, I chalked it up to just the normal wear of life. A doctor put me on Vitamin D, and I didn’t question it further.

Then, in 2012, I was getting ready to go on a girls’ trip with friends, and I was in the mall shopping for clothes. After a few hours, I felt a tightness around my stomach and groin. What I know now is this is what’s called the “MS hug,” but at the time I thought I may have thrown my back out or pinched a nerve. I didn’t worry about it, thinking I was going on a cruise in two days and would get a massage. But it didn’t let up. It started intensifying. And I’ll never forget, the last day of the cruise, I was struggling to hold my fork. I couldn’t gauge when I had to go to the bathroom. I had no feeling from the chest down. I was able to walk without a problem – I just couldn’t feel it.

When I got home, I went straight to the emergency room, and one of the residents asked, “Does anybody in your family have MS?” There’s a family history, but even then I didn’t think that was it – I still thought I had just thrown my back out. I wound up going to a neurologist and they diagnosed me with MS.

A few months after that first flare-up, the symptoms went away pretty much as if it had never happened. I don’t have as much sensation in my fingers as I used to, but it’s so subtle I don’t usually notice it. Right now, I can’t really feel my toes. Sometimes it’ll feel like I have a piece of tape on the bottom of my foot, and then the sensation comes back. Other than that, I’m perfectly functional. I’m on medication and haven’t had any serious problems. With MS, the symptoms come and go. It doesn’t stop my everyday life.

Talking about my condition

I’m very open about it, and all of my co-workers know, although I’m only now starting to tell patients about it since taking this job. I feel like having MS myself makes me a lot more empathetic. The thing with this disease is that I can have a symptom that someone else with MS will never experience, and vice versa. I understand. I know symptoms can be anything. Some of the medications they’re taking, I’ve taken myself, and I know the side effects – fatigue, depression, nausea – that can be barriers to sticking to their prescriptions. A lot of these medications also require self-injections, so I can talk patients through ways to do that with less discomfort or anxiety. Whenever I counsel them, I’m drawing on my own personal experience and the research I’ve done over the years.

Not by design

It’s actually just a happy coincidence that I now work at a pharmacy that specializes in MS. When I joined Walgreens a couple of years ago when Walgreens acquired the Rite Aid store I was working at, I realized the company had these specialty sites, and I wanted to try something different. I started at Touro as a floating pharmacist – meaning it was one of multiple Walgreens where I worked shifts. This site only became MS-certified a few months ago. So MS isn’t the reason I’m here, but because I do know MS, it’s a great fit.

Home family

My husband is a first responder in law enforcement, so my daughters have two parents doing essential work right now. I have a 23-year-old and a 12-year-old, so my older daughter is acting as sort of a limited babysitter for her sister. At home, we walk in the neighborhood and try to exercise – and stay away from the TV. I don’t really care to see a lot of the negativity in the news right now. I prefer to find the positives.

Work family

Here with my staff, we talk a lot, making sure everyone is emotionally sound during the pandemic. We know we can all express ourselves freely and confidentially. We help each other: “Do you need anything? Because I’m going out to the store, and if I see it, I’ll get it.” It can be hard for us to get out for necessities sometimes. The hospital has been great because in their cafeteria, they sell staples as a convenience for employees in the building: toilet paper, bread, eggs, milk and orange juice. They know we’re all here doing important work, looking after some of the most vulnerable people in our community.

SPECIALTY PHARMACY AT A GLANCE

• 300-plus Walgreens community specialty pharmacies (free-standing and at medical centers)
• 1,300-plus Walgreens locations that specialize in a particular condition:
  • HIV: 1,000-plus
  • Organ transplants: 100-plus
  • Hepatitis C: 90-plus
  • Oncology (cancer): 70-plus
  • Multiple sclerosis: 20
  • Cystic fibrosis: 20
  • Infertility: 14